Predicting the analgesic effect to oxycodone by ‘static’ and ‘dynamic’ quantitative sensory testing in healthy subjects

• Published in: Pain (Amsterdam) Vol. 151; no. 1; pp. 104 - 109
• Main Authors: Eisenberg, Elon, Midbari, Ayelet, Haddad, May, Pud, Dorit
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier B.V 01.10.2010; Lippincott Williams & Wilkins, Inc; Elsevier
• Subjects: Adult; Analgesics; Analgesics - pharmacology; Analgesics - therapeutic use; Analysis of Variance; Biological and medical sciences; Cold pressor test (CPT); Cross-Over Studies; Diffuse noxious inhibitory control (DNIC); Double-Blind Method; Female; Human viral diseases; Humans; Hyperalgesia - drug therapy; Hyperalgesia - etiology; Infectious diseases; Male; Medical sciences; Neuropharmacology; Opioid analgesia; Oxycodone - pharmacology; Oxycodone - therapeutic use; Pain Measurement - methods; Pain Threshold - drug effects; Pharmacology. Drug treatments; Physical Stimulation - adverse effects; Predictive Value of Tests; Quantitative sensory testing (QST); Statistics as Topic; Temporal summation; Thermal pain threshold; Time Factors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Young Adult; Temporal summation; Cold pressor test (CPT); Diffuse noxious inhibitory control (DNIC); Opioid analgesia; Thermal pain threshold; Quantitative sensory testing (QST); Temperature; Prevalence; Cold; Methodology; Diffuse noxious inhibitory controls; Oxycodone; Variability; Tolerance; Environmental factor; Analgesia; Analgesic; Pain; Treatment; Placebo
• ISSN: 0304-3959; 1872-6623; 1872-6623
• DOI: 10.1016/j.pain.2010.06.025

The large inter-individual variability in the magnitude of analgesia in response to opioids and the high prevalence of adverse events associated with their use underline the clinical importance of being able to predict who will or will not respond to opioid treatment. The present study used both static and dynamic quantitative sensory testing (QST) on 40 healthy volunteers in order to test whether this methodology can predict the analgesic effects of oral oxycodone, as compared to a placebo, on latency to onset, pain intensity, and tolerance to the cold pressor test (CPT). Static QST consisted of measuring heat and cold pain thresholds. Dynamic QST included measurements of the magnitude of the diffuse noxious inhibitory control (DNIC)-like effect and of temporal summation (TS). Results showed that oxycodone, but not the placebo, significantly elevated the latency and tolerance to cold pain and significantly reduced pain intensity. The static QST results showed that heat pain thresholds predicted the magnitude of reduction in pain intensity in response to oxycodone treatment ( F (1,22) = 5.63, p = 0.027, R 2 = 0.17). The dynamic QST results showed that TS predicted the effect of oxycodone on the tolerance to CPT ( F (1,38) = 9.11, p = 0.005, R 2 = 0.17). These results suggest that both static and dynamic QST have the potential to be useful in the prediction of the response to opioid treatment.